Immune-mediated diseases and immunodeficiencies associated with thymic epithelial neoplasms

J Clin Immunol. 2012 Jun;32(3):430-7. doi: 10.1007/s10875-011-9644-1. Epub 2012 Jan 8.

Abstract

Introduction: This retrospective study aimed to characterize the clinical hematological and immunological features of patients with thymic epithelial neoplasms.

Methods: From a cohort of 512 patients with thymic epithelial neoplasms, 79 patients diagnosed with autoimmune/immunodeficiency conditions or signs and/or symptoms suggesting an autoimmune or immunodeficiency state were evaluated by standard immunological and hematological testing.

Results: Elevated percentages of CD2+, CD3+, and CD8+ lymphocytes were observed in 44 (57.1%), 33 (41.8%), and 32 (40.5%) patients. Low CD4+ and CD19+ percentages were observed in 25 (31.6%) and 36 (46.2%), respectively; CD4+:CD8+ ratios were inverted in 18 (22.8%). IgG, IgA, and IgM levels were low in 12 (15.8%), 9 (11.7%) and 15 (19.7%) patients, respectively. Patients with immunodeficiency condition(s) were more likely to have high CD8+ percentages (p = 0.040), low CD19+ percentages (p = 0.025), and/or inverted CD4+/CD8+ ratios (p = 0.034). Patients with autoimmune condition(s) were more likely to have a high/normal CD4+ percentage (p = 0.038). High CD2+ percentages were associated with lower mean IgG and IgA levels (p = 0.030 and p = 0.017, respectively). High CD3+ and CD8+ percentages were associated with lower mean IgA levels (p = 0.046 and p = 0.013, respectively). Low CD19+ percentages were associated with lower mean IgG and IgA levels (p = 0.004 and p < 0.001, respectively).

Conclusion: Signs/symptoms and history of autoimmune and immunodeficiency conditions among patients with thymic epithelial neoplasms are associated with high frequencies of abnormalities in immunoglobulin levels and lymphocyte immunophenotypes, suggesting a role for their assessment.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antigens, CD / immunology
  • Autoimmune Diseases / blood
  • Autoimmune Diseases / immunology*
  • Female
  • Humans
  • Immunoglobulins / blood
  • Immunologic Deficiency Syndromes / blood
  • Immunologic Deficiency Syndromes / immunology*
  • Lymphocytes / immunology
  • Male
  • Middle Aged
  • Neoplasms, Glandular and Epithelial / blood
  • Neoplasms, Glandular and Epithelial / immunology*
  • Retrospective Studies
  • Thymus Neoplasms / blood
  • Thymus Neoplasms / immunology*
  • Young Adult

Substances

  • Antigens, CD
  • Immunoglobulins

Supplementary concepts

  • Thymic epithelial tumor